Case Study #3

 

  • This case study solidified the intersections of homelessness, mental health concerns, and reliance on governmental officials. It also appealed to the interest that I have in having some kind of involvement with psychiatry- whether that be through a residency or fellowship after medical school. This client was a very interesting one. They were introduced to me through Cassie’s programming attempting to provide housing for HIV+ persons. This patient had been in a state of mind bordering between mania and psychosis for approximately a month. The patient was effectively homeless and living in a tent. My first interaction with this client was when I was asked by my coworkers to assist with monitoring the client so they did not disappear into the street. Another agency was filling out a mental hygiene appeal- known as a 302 in Pennsylvania. This allows the state to involuntarily commit individuals to mental health institutions. In West Virginia, the legal system is extremely suspicious (and in my opinion, unethical). Many of the magistrate judges here are elected and not appointed, meaning they have no legal background or experience with judging. The client was in this state of borderline psychosis where they were obsessing over alternate dimensions, talking about themselves as an omniscient god, divulging horrific traumas through poetry stanzas, jumping out of cars into the highway, and consuming massive amounts of food. While all of this was communicated about the patient to create a foundation of imminent psychosis, magistrate judges turned down the mental hygiene because “there was no immediate threat of suicide or harm to others.” Since the magistrate judges have no training in the legal system or exposure to mental health, their uneducated status prevented them from knowing that the definition of psychosis includes the threat of suicide or harm against others. The denied the 302, to my knowledge, twice. 

  • The client was staying in a hotel so that the social services could monitor their whereabouts as they were attempting to provide housing for this client. They needed to meet with their landlord in a few days- so they needed to keep their eyes firmly trained on this client. The second time I was introduced to this client was at the end of the month when all of my coworkers and the collaborative social service (that had submitted the 302) needed to finish paying bills and finish case notes. This meant that I was the one sent to the hotel to prepare the client, take them to get food, and bring them to the Covenant House to be monitored while they were awaiting their meeting with their landlord. While I am not cleared to be driving patients around, especially one of that volatile disposition, I couldn’t avoid the way that the cookie had crumbled around me. While I got an official tap on the hands, it showed just the depth of my involvement and how reliable I was. I definitely know that it was appreciated. The patient was less manic that day, but still was claiming to have owned an interdimensional cat that could teleport to check on the people they cared about. The patient was also claiming to have known every person that they saw, repeating over and over that it was their mother’s boyfriend. I had to use many redirect techniques to prevent them from following everybody they saw. Ultimately, the last that I heard of the patient was that the landlord did intend to let the client be housed on their property. The downside, unfortunately, is that the property wouldn’t be ready for some time. This effectively left the client on the street until the house was available for move-in. Although, with the multiple denials of the 302, we were unsure if this client would receive the intensive treatment that they needed to hold a mental state that would even be conducive to living in a residential property.

Comments

Post a Comment

Popular posts from this blog

Week Five (7/5/22-7/8/22)

  This week at WV Covenant House revealed more aspects of the social work environment to me. While I didn’t too much, that spoke volumes in and of itself about how this agency and state functions. The main two tasks that I had this week was to reorganize our library in the queer resource room- separating sections based on fiction and non-fiction. I was able to separate everything into broad categories of academic non-fiction, memoir non-fiction, guide book non-fiction, novel fiction, and 18+ fiction. Once I had separated into this broad categories, I was able to go back and comb through each individual section to organize by common themes such as history of the queer community or health commentary by doctors. This project took me approximately three half-days. The other project that I was assigned to, this week, was making pledges to utility companies to pay client bills. Unfortunately, there was some complications with finances and Covenant House needed to make pledges rather than dir
Read more

Week Six (7/11)-(7/15)

 Unfortunately, I didn't do anything too phenomenal this week because one of my roommates contracted COVID-19 and I quarantined from our apartment from Wednesday until the morning of Monday the 18th. For the first two days of the week, I did find experience in applying for West Virginia's Housing Urban Development and Public Housing assistance. It revealed to me how tedious, strenuous, and overwhelming the process is to search for help. If you're missing any pieces of the application, it won't be processed. There are a variety of hoops to jump through when attempting to look for housing assistance. Not only are some applications forced to be paper rather than fast, speedy online applications, but some people don't have the necessary paperwork like access to their social security cards or birth certificates. The stigma that revolves around poverty is overwhelming, painting a picture that those looking for assistance are merely lazy. The process of applying for assist
Read more

Week Seven (7/18/22-7/22/22)

This week at the Covenant House, while it was busy because it was nearing the end of the month, was a bit more monotonous compared to the others weeks. I didn’t have any large, major tasks beyond submitting applications for public housing for one of my clients. Most of the social workers were delving into the world of grant reports, attempting to produce a stellar report within the most conducive amount of time. I helped some individuals file paperwork while they wrote their reports and some odds and ends paperwork floating around the building. My main task this week was to operate the main phone. The individual who normally answers the phone at the Covenant House is contracted through a third party that normally will decrease their hours at the beginning of their work cycle. From this, they will increase their hours back to 40 after some many weeks. As of result of this, I was responsible for the phones in the afternoon. The majority of calls that we would receive is about utilities-
Read more